How do we hear?
is a complex process involving the three major parts of the ear:
the outer, the middle and the inner ear. The
outer ear collects surrounding sound waves and funnels them through
the ear canal down to the eardrum, the beginning of the middle
ear. The sound waves cause the
eardrum to vibrate. Three tiny bones attached to the
eardrum convert the vibration into pressure waves and move them down to
the inner ear. There the cochlea, a fluid-filled, bony maze full of
minute hair cells, turns the pressure waves into electro-chemical impulses
which then travel to the brain where they are interpreted as the sounds
causes hearing loss?
A number of
conditions can cause a disruption in the hearing process and lead to
hearing loss. The two most common types of hearing loss are conductive and
occur when the outer or middle ear is unable to properly conduct
sound and pressure waves to the inner ear. These losses are
common in children with ear infections and in anyone with blockage
caused by earwax, bacterial infection, allergies, trauma to the ear,
congenital malformations or calcium growths. Such hearing losses are
usually temporary and can often be successfully treated by medical or
are a result of nerve damage to the hair cells, or nerve fibers, in
the inner ear. Causes can be genetic or congenital, or they can stem
from an illness, disease, chemicals or medications. The most common
causes, however, are attributed to aging and prolonged exposure to
noise. Such hearing losses are usually permanent and typically treated
with hearing aids or, in severe cases, cochlear implants.
do I know if I have a hearing loss?
way to find out if you have a hearing loss is to be tested by an
audiologist. In fact, it makes sense to have your hearing checked on a
regular basis just as you do your vision, particularly if you are over 40
years old. To see if you have any warning signs of hearing loss, take our
What happens if I don't get my
hearing loss treated?
a medical condition is causing the damage, not only is your hearing
affected, your overall health could get worse if left unattended. When
your auditory system is damaged, the brain is no longer stimulated by
sound impulses. If too much time elapses before treating the hearing loss,
the brain forgets how to recognize certain sounds. When this happens,
therapy is necessary to retrain the brain to hear these sounds.
What is an audiologist?
are healthcare professionals who have earned a master’s and/or doctoral
degree (AuD) in audiology, the science of hearing. Audiologists are
trained in the prevention, diagnosis and non-medical treatment of hearing
disorders. They are clinically, academically and professionally trained to
determine which hearing losses need medical attention and which can be
corrected with hearing aids or other assistive listening tools. Many
dispense hearing aids, which requires state licensing. Some are affiliated
with professional organizations that provide continuing education
programs, codes of ethics and standards of care.
What is a hearing aid specialist?
Aid Specialists are trained and licensed to perform basic hearing tests
and dispense hearing aids to individuals who specifically seek hearing
aids, not diagnostic services.
Why go to an audiologist for a
are the most qualified professionals to test, select and verify the
performance of hearing aids.
have earned a master’s or doctoral degree in audiology and have
completed a full-time internship program.
conduct a complete hearing assessment – patient history, physical
examination and audiometric evaluations – to determine if a hearing
aid or a referral to a medical specialist is appropriate.
have extensive testing tools to help pinpoint the cause of hearing
loss, and they have state-of-the-art equipment to customize hearing
provide patient education and training to help ensure the greatest
success in hearing treatment and continuity of service for the life of
the hearing aid.
What qualifications should I look
for in an audiologist?
audiologists have earned either a masters or doctorate in audiology. All
have completed clinical training and, if they dispense hearing aids,
should be licensed to do so. Other factors to consider include:
– how long have they been serving patients?
– what level of training and education have they achieved? Do they
participate in continuing education programs on a regular basis?
services – does their scope of services include a broad range of
tests for hearing loss and hearing-related disorders or are their
services restricted to amplification testing for dispensing hearing
– are they known in the community? Do they come well recommended?
affiliations – do they belong to professional organizations that
provide continuing education, a code of ethics, standards of practice
and information on the latest testing and treatment techniques?
What happens when I visit an
audiologist's office for a hearing exam?
first visit to an audiologist’s office takes about an hour. It focuses
on three areas that help determine the nature of your hearing loss and the
personal history is taken to learn what may have influenced your
hearing loss – certain illnesses, your parents’ hearing,
occupational background, exposure to noise.
audiologist will examine your ears to see if your hearing loss is due
to damage or blockage in the outer ear.
receive a series of hearing tests to establish the level at which you
hear certain tones and pitches and recognize specific words.
It is at
this point that your audiologist will either refer you to a physician or
surgeon for medical treatment or discuss options for enhancing your
hearing with listening aids.
What is the best hearing aid?
hearing aid is best. An audiologist will help determine what is best for
you after diagnosing your hearing loss and discussing your own
personal needs. Considerations would include your occupation, lifestyle,
budget, personal taste, any physical limitations you have and the nature
of your hearing loss.
aids have made significant advances in recent years, both technologically
there are three types of hearing aids – analog, digitally programmable
and 100% digital.
analog circuits are the most basic, the least expensive and
have fewer capabilities for hearing in specific surroundings. They
essentially provide amplification, with volume controlled manually.
digitally programmable hearing aids have an automatic volume
control, programmed by the audiologist, and may include more than one
microphone to accommodate various listening situations.
digital hearing aids are the most sophisticated and feature advanced
circuitry and unique signal processing capabilities. They contain tiny
computers with dual microphones and multi-channel signal processors
(up to 15 channels) that automatically adjust directional noise and
sound frequency so that speech can be distinguished from background
technology gives audiologists maximum control over sound quality and
amplification. What’s more, it enables them to customize your hearing
devices so that you hear what you want to hear and minimize what you
don’t want to hear, such as background noise.
are four major styles of hearing aids – behind the ear, in the ear, in
the canal and completely in the canal – to house whatever technology is
chosen. Style selection is based on both physical and hearing-related
factors as well as personal preference.
Behind the Ear (BTE)
models, the electronics are housed in a case that fits behind the ear.
Tubing and an ear mold route the sound to the ear canal. In general,
BTE hearing instruments can provide the maximum amount of
the Ear (ITE) fit within the outer ear and extend into the ear
canal. They are the least expensive and easiest to operate.
the Canal (ITC) are smaller than ITEs and fit further into the ear
canal. They are an option for mild to moderate hearing losses.
in the Canal (CIC) fit even further in the ear canal, closer to
the eardrum. The least visible, they are restricted to persons with
ear canals large enough to accommodate them. They are also the most
What can I expect from my hearing
aids work very well when they are properly fitted and programmed.
Initially, you’ll be aware that you have hearing aids in your ears, and
your voice may sound strange. However, your listening skills should
improve as you become accustomed to amplification. While hearing aids will
not restore your hearing capabilities to pre-existing levels, you should
expect the following results:
hear sounds you haven’t heard in a long time – paper rustling,
birds singing, your car signal device clicking.
hearing in quiet and moderate backgrounds will have improved
(one-on-one and small group conversations, TV). So, too, when using
the telephone or cell phone.
it is noisy, your hearing will not be as good as it is in quiet
speech will be more audible.
How much do hearing aids cost?
on the technology and style, hearing aids can range from $1,500 to $3,000
per hearing aid. The most expensive are not necessarily the best solution
for everyone. The choice should be determined by the nature of your
hearing loss, your budget, style preference, occupation, lifestyle and
How long do hearing aids last?
take good care of your hearing aids, they should last about six years.
During this time, your hearing may change, typically necessitating a
programming adjustment by your hearing aid dispenser or audiologist.
How do I care for my hearing
the lifetime of your hearing aids, follow these general guidelines:
your hearing aids regularly as instructed by your audiologist and
hearing aid manufacturer.
getting them near excessive heat.
spent batteries immediately.
applying hair spray while wearing hearing aids.
not use alcohol or cleaning fluid for cleaning.
Where do I go for more
information about hearing aids?
contact us at The Monterey Hearing & Balance Center or visit our Resources
What should I know about hearing
typically last 7 to 14 days depending on the number of hours used per day.
You will hear a chirping noise right before they stop working. All hearing
aid batteries are air-activated. To extend their life, the battery door should be
opened when not in use.
Batteries are toxic if swallowed, requiring immediate medical attention.
Keep them away from children and pets. Also, never put your batteries in
the refrigerator or freezer, as moisture will corrode them.
What other assistive listening
devices are available besides hearing aids?
a number of Assistive Listening Devices (ALDs) that amplify sounds for use
in specific situations, such as watching TV or attending a movie, a play
or presentation. There are also ALDs to replace standard equipment, such
as alarm clocks, telephones and smoke detectors
What are cochlear implants?
implants are for patients with severe to profound sensorineural hearing
loss who would not benefit from hearing aids. A cochlear implant allows
sound waves to bypass the nonfunctional inner ear and convert them into
impulses that stimulate the cochlear nerve. This is done by surgically
placing an internal receiver beneath the skin behind the ear and an
electrode array into the cochlea. The electrical signals are then
manipulated by an audiologist to maximize speech perception. The brain
then interprets these electrical impulses as recognizable sounds.
What can I do to protect myself
from hearing loss?
Repeated exposure to loud noises can have a cumulative, damaging effect on
your hearing. At work, wear hearing protection if your job involves noise
levels exceeding 90 decibels. You should also guard your hearing outside
of work – at a rock concert, while hunting, when operating power
equipment, even drying your hair. Earplugs that typically reduce noise
levels by 15 to 20 decibels provide generally adequate protection, but in
extremely loud situations, we recommend that you wear earmuffs over
What is tinnitus?
(pronounced tin-it-tis) is a perceived sound in the ears, most
often reported as a ringing though some people hear hissing, roaring,
whistling, chirping or clicking. The noise can be constant or intermittent
with a range from very soft to very loud.
What causes tinnitus?
causes of tinnitus can be difficult to identify. Some of the known factors
that cause or exacerbate tinnitus conditions include: hearing loss and
exposure to loud noise (the two most common causes), earwax, certain
medications, ear and sinus infections, ear diseases and disorders, jaw
misalignment, tumors, thyroid conditions, anemia, stress, hypertension and
some physical traumas. It’s important that you receive tinnitus-specific
testing. The more comprehensive your diagnosis, the more successful your
How is tinnitus commonly treated?
medical attention isn’t able to eliminate tinnitus, alternative
treatments may help manage it:
aids are particularly successful when hearing loss is in the same
frequency range as the tinnitus.
Maskers resemble hearing aids and produce a band of noise to cover
up the tinnitus.
feedback teaches a relaxation process to control the response to
stress and how it influences your tinnitus.
therapy alters negative thoughts about tinnitus rather than
treating the tinnitus itself.
Retraining Therapy helps you become less aware of the sounds of
their tinnitus through counseling and the use of in-the-ear sound
can be prescribed when the underlying cause is attributable to
anxiety, depression or sleep deprivation.
Do you have a question about
hearing, hearing aids and don't see the answer on
this page? Ask Michele at The Monterey Hearing and Balance Center here:
The information on this website is for educational purposes only and
should not be interpreted as rendering medical advice or treatment. Please
consult The Monterey Hearing & Balance Center or your personal
physician for answers to specific questions about your hearing and balance
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